2of3Of the 37 percent of voters nationwide who planned to vote for President Donald Trump in the 2020 election, more than a third of Republicans and 37 percent of Independents said in a survey conducted by the Texas Medical Center that they would change their mind if his policies led to an increase in the uninsured. The survey results were released Sept. 12, 2018. Here, Trump is shown in the Oval Office in this Sept. 11, 2018, photograph.Photo: ZACH GIBSON, Contributor / AFP/Getty Images

When the majority of voters across the country head to the voting booth in November and again in 2020, the politics of health care will not be far from their thoughts.

That’s the finding of the fourth annual Texas Medical Center’s national consumer survey, released Wednesday, which gauges attitudes on health issues, ranging from support of President Donald Trump’s policies to whether foods laden with fat and sugar should cost more.

Titled, “The Nation’s Pulse,” the survey questioned 5,038 people across 50 states, including 1,018 people in Texas. Respondents were both Democrats and Republicans but also included those who identified as Independent.

Nearly two-thirds, or 61 percent, said they would be likely to only vote for candidates who promise to make fixing health care a priority. Additionally, the majority of voters said it was important that candidates share their views on such hot-button issues as expansion of Medicaid. Those views held both in states that expanded Medicaid under the Affordable Care Act and in the 17 states, including Texas, that did not.

Across all political parties, 60 percent of Texans favored a Medicaid expansion, according to the survey. This comes despite years of steadfast opposition from state leaders. It also closely mirrors a similar survey in June by Houston-based Episcopal Health Foundation and the Kaiser Family Foundation that found 64 percent of Texans wanted a Medicaid expansion.

Survey responses at a glance

Likelihood to only vote for candidate who wants health care fixed:

Democrats: 68 percent

Republicans: 60 percent

Independent: 53 percent

Plan to vote for Donald Trump in 2020:

U.S (all parties).: 37 percent

Texas (all parties): 38 percent

2020 Trump voters who would change their mind if uninsured rate rises:

But perhaps most striking was that “Medicare for All” health coverage — once politically unthinkable in Texas —found surprising favorability with 55 percent in the state saying they would support it. That compares with 59 percent nationwide, the survey found.

“With health care so expensive and increasingly unaffordable, the respondents told us that it is important to try to fix it,” said Dr. Arthur “Tim” Garson, director of the Texas Medical Center Health Policy Institute which led the study.

While the bitter health care debate of a year ago has slipped mostly out of the headlines, it apparently has not slipped from people’s minds, political operatives from both parties said Tuesday.

Neither Glenn Smith, an Austin-based progressive consultant, nor Jamie Bennett, vice president at Potomac Strategy Group, a right-leaning political consulting firm, were especially surprised when told of the survey results.

“I think (health care) is the most critical domestic issue that we face today,” said Smith, adding that worries about affordability and access are “ever-present” in people’s lives.

“Health care is a very important issue for our elected leaders to solve,” agreed Bennett in an email, “It makes up the majority of the federal budget and affects every American at some point in their lifetime. I think health care will continue to be a central issue in the mid-terms and 2020 presidential election — especially given the inaction from the federal level.”

Looking ahead to 2020, the survey zeroed in on Trump supporters. Of the 37 percent of voters nationwide who planned to vote for the president, more than a third of Republicans and 37 percent of Independents said they would change their mind if his policies led to an increase in the uninsured.

Such potential defection did not surprise Smith. “That is one of the things that could knock significant numbers from his base,” he said.

Garson cautioned, though, the presidential race is still two years away. “You don’t know until Election Day what people will do,” he said,

There were differences, however, in how party affiliation affected priorities. While reducing costs was considered the highest priority across the board, Democrats listed universal coverage as next, while Republicans and Independents said affordability was the second highest priority.

In other issues, the survey found nearly half of Americans, including those in Texas, supported lowering the legal blood alcohol limit while driving to 0.0. It is currently .08 in Texas. Also, an overwhelming majority in all states wanted the age of buying tobacco products raised to 21, and more than half said that foods that lead to obesity should cost more.

Jenny Deam is an investigative reporter focusing on abuses in the health care system. She came to the Houston Chronicle in March 2015 from Denver, trading thin air for thick. Prior to joining the Chronicle she was a special correspondent for the Los Angeles Times based in Denver. She has been a reporter for the Denver Post, the Tampa Bay Times, the Kansas City Star and has written for regional and national magazines. She is a graduate of Washburn University.